Clinical Services and Programs

Juvenile Health Services is dedicated to meeting the health and health education needs of the youths in juvenile justice facilities. Professional medical staff screen and assess youth upon admission, develop healthcare plans and provide appropriate interventions and/or follow-up that may include referral for specialty assessment and intervention. Oversight and management of health care services in juvenile justice facilities are provided by supervisory medical staff assigned to the Central Office. These staff are responsible for health care services evaluation, problem identification, solution recommendations and the facilitation of needed changes and supports to provide positive health outcomes for youth. Guidance to center staff also focuses on the provision of appropriate health education and health skill development, acknowledging that adolescence is a unique and critical stage of human development. Health literacy and competence is a pervasive focus.

Juvenile Mental Health and Positive Youth Development Programming Services is a complex and pivotal segment of juvenile healthcare. Juveniles committed to North Carolina's juvenile justice system present with multiple and complex behavioral health needs. Over the past two years, youth confined in youth development centers (YDCs) carried an average of three distinct mental health diagnoses, with 60 percent having co-occurring mental health and substance use disorders. To meet these needs, youth are assigned to a licensed mental health clinician (LMHC) upon admission to a YDC. LMHCs screen and assess youth upon admission and provide appropriate psychotherapeutic interventions, including referral to contracted psychiatry staff or to specialized mental health settings in the community, when warranted. Because of the high preponderance of trauma-related disorders among confined juveniles, evidence-based mental health interventions such as Trauma-Focused Cognitive Behavior Therapy and Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS) are available at all YDCs.

Juvenile Justice enacts a comprehensive strategy designed to prevent and reduce juvenile crime and delinquency. In keeping with this strategy, LMHCs assess each youth upon admission to youth development centers for risk factors that are known contributors to delinquent behavior. Guided by assessment results, LMHCs provide individual and group treatment interventions targeting dynamic criminogenic (crime-producing) risk factors. These interventions are designed to minimize risk factors that contribute to delinquent behavior and build protective factors that enable the flourishing of law-abiding, pro-social attitudes and behavior. The work of the LMHCs is supervised by psychological program managers. Psychological program managers also provide assessment and treatment support for complex mental cases and may provide administrative oversight for social work supervisors and nurse supervisors at a youth development center campus. 

The responsibility for reducing juvenile crime is also shared by direct care staff at juvenile justice centers. These staff are trained to create and maintain a therapeutic environment in the centers and to provide therapeutic interactions designed to promote youth's development and display of pro-social skills and behavior. Staff are trained in models of care that are based on research-supported principles that address risk factors for antisocial and delinquent behavior. Training support and model fidelity monitoring are provided by a central office-based LMHC who also identifies and coordinates internal and external resources in an ongoing effort to enhance staff effectiveness as agents of change.  

The comprehensive strategy also involves the provision of evidence-based clinical and non-clinical intervention and prevention programs to at-risk youth under the auspices of Juvenile Crime Prevention Councils (JCPCs) across the state. Technical assistance and consultative support to JCPC Consultants in the areas of mental health assessment and treatment, criminogenic factor reduction and program implementation science, is provided by a psychological interventions and program implementation specialist who works closely with the JJ Community Programs section as well as JJ secure centers.

Social Work Services is responsible for coordinating and monitoring all services relevant to the committed youth's individualized service plan and serves as the primary contact to the family, court counselor and community agencies while placed at a youth development center. Upon admission, social workers compile relevant social history and provide a community re-entry plan to be reviewed at each monthly multidisciplinary service planning meeting. They gather information from the interdisciplinary team in order to prepare a written YDC Discharge Summary and coordinate and chair post-release supervision planning conferences prior to community re-entry. This conference includes the juvenile, parent or guardian, court counselor, representatives of involved community agencies and stakeholders as well as YDC staff. Social workers help ensure that a plan of supervision is developed that is based on the protection of the public and the specific needs of the juvenile. Oversight and technical support is provided by center-assigned social work supervisors and the statewide Juvenile Social Work Director and Assistant Director.